A Progress Report

Problem Synopsis: The United States has some of the highest health expenses in the world, but ranks 32nd in terms of life expectancy, a clear indication that good health is determined not only by the money spent on health care, but also on the built environment and social and economic circumstances. Health impact assessments are a tool for measuring the impacts of public policy and programs on health, but until quite recently their use was rare in the United States.

Synopsis of the Work: The Health Impact Project, a partnership with the Pew Charitable Trusts, promotes the field of health impact assessments. Activities include guiding 23 RWJF-funded demonstration projects across the country, collaborating with local, state and federal officials to advance the concept, and providing training through the National Network of Public Health Institutes (NNPHI).

RWJF also funded the National Research Council to develop a framework and guidelines for HIAs and the Pew Charitable Trusts, which it published as Improving Health in the United States: The Role of Health Impact Assessment. Three other foundations, Blue Cross Blue Shield of Minnesota, the California Endowment and the Kresge Foundation, partnered with RWJF to support six additional HIAs in their areas of interest.

Key Findings/Results

The National Research Council presented a framework for completing HIAs built on six steps: screening, scoping, assessment, recommendations, reporting and monitoring and evaluation.

Twenty-three RWJF-funded HIA demonstration projects were launched around the country in 2009 and 2011. As of August 2012, about half of those were nearing completion and the rest were underway. The Health Impact Project's coordinating center, housed at Pew, provided an array of technical assistance.

The Health Impact Project convened a national meeting in Washington and is working with state and local government representatives to advance the use of HIAs in their communities.

At the federal level, the Health Impact Project conducted a workshop and made presentations about HIAs to members of the National Prevention, Health Promotion and Public Health Council.

To build the capacity of their members, the National Network of Public Health Institutes established two regional HIA training centers, offered a two-day training to staff from 10 public health institutes, and funded two demonstration projects.